title: Continued growth after limited physeal bridging.
abstract: BACKGROUND
  After any physeal injury, the primary concern is the possibility of some pattern of growth alteration, particularly transphyseal bridging that may cause lasting deformities and impact subsequent patient care. Small areas of physeal bridging, however, may be associated with continued growth, rather than impairment.
  
  
  METHODS
  Seven patients with small central physeal bridges of the distal femur were identified. Demographic data and imaging studies were reviewed.
  
  
  RESULTS
  Radiography identified small, relatively centrally located transphyseal osseous bridging that was associated with a linear (longitudinal) region of osseous density extending from the physeal bridge proximally into the metaphysis. This linear striation disappeared at the metaphyseal/diaphyseal gradation, an area of progression proximally from metaphysis to diaphysis. Only 1 patient had a significant leg length inequality. Magnetic resonance imaging confirmed the intrametaphyseal linear sclerotic bone and its disappearance with diaphyseal remodeling.
  
  
  CONCLUSIONS
  Small, central transphyseal osseous bridges may form after radiologically confirmed acute physeal injury. Normal physiological (hydrostatic) growth forces can be sufficient to overcome such limited central bridging and allow continued, essentially normal, longitudinal growth.
  
  
  METHODS
  Level IV (retrospective case series); anatomic study.
authors.affiliation: *Department of Orthopaedics, Atlanta Medical Center ‡Skeletal Educational Association, Atlanta, GA †Carolinas Medical Center, Charlotte, NC.
authors.forename: Justin C
authors.initials: JC
authors.lastname: Kennon
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Ganey
authors.forename: Raymond Glenn
authors.initials: RG
authors.lastname: Gaston
authors.forename: John A
authors.initials: JA
authors.lastname: Ogden
mesh_terms: D001846:Bone Development / Q000502:physiology*; D002648:Child; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D006801:Humans; D008297:Male; D011859:Radiography